Which medications should I review in older patients to reduce their risk of falls?

In older patients, to reduce their risk of falls, you should review the following medications:

• Psychotropic drugs (such as benzodiazepines, antidepressants, and other psychoactive medicines) should be reviewed and discontinued if possible, ideally with specialist input, because they increase the risk of falls.
• Drugs that can cause postural hypotension, including antihypertensive medications, should be assessed and adjusted as appropriate to reduce fall risk.
• Polypharmacy should be reviewed comprehensively to identify any medicines that may contribute to falls risk.

For people taking psychotropic medicines, it is important to discuss the increased risk of falls and plan withdrawal if appropriate, possibly involving specialist mental health services.

Medication review is a key component of multifactorial falls risk assessment and intervention in older people at risk of falling.

Vitamin D supplementation is not specifically recommended to reduce falls risk but is advised to maintain bone and muscle health.

These recommendations are based on NICE guidelines and expert consensus on falls prevention in older people.

References: ¹,²,³